Antenatal presentation of hereditary lymphedema type I.

Fetal edema can present as limited subcutaneous edema, fluid accumulation in body cavities or hydrops fetalis. Hydrops fetalis is the end stage of a variety of fetal/maternal disorders and nonimmune etiology represents more than 3/4 of cases. Lymphatic dysplasia may account for a subset of patients with nonimmune and "idiopathic" hydrops fetalis, fetal chylous ascites or chylothorax. We present two unrelated patients with antenatal features of hereditary lymphedema syndrome, in whom Milroy disease was diagnosed after birth. At least, 20 genes have been identified to cause primary lymphedema, with sometimes antenatal features. Hereditary lymphedema syndrome should be considered in cases of nonimmune hydrops fetalis/fetal edema after ruling out the more common etiologies.

[Prenatal diagnosis of omphalopagus conjoined twins at 13 weeks of amenorrhea]. / Découverte anténatale de jumeaux conjoints omphalopages à 13 semaines d'aménorrhée.

Conjoined twins are a rare occurrence. We present a case of conjoined twins at 13 weeks' gestation. This case demonstrated the possibility of making an accurate diagnosis of conjoined twins and delineating the extent of organ sharing in the first trimester. This analysis and the discover of another anomalies can help the parents with the option for pregnancy termination. Early diagnosis and precise delineation of the shared organs of conjoined twins are essential for optimal obstetric and postnatal management.

[Non-steroidal anti-inflammatory agents and pregnancy. A study of renal and digestive toxicity of niflumic acid in the perinatal period]. / Anti-inflammatoires non stéroïdiens et grossesse. Etude sur la toxicité rénale et digestive en période périnatale de l'acide niflumique.

We report a case of intrauterine exposure to niflumic acid in a preterm neonate (35 weeks of gestation). The mother received niflumic acid (750 mg daily) during the last four days of gestation. Severe oligohydramnios was present. A transient neonatal renal failure, but also abdominal complications were observed for several days. Maternal and neonate niflumic acid levels were studied and showed an important placental transfer. Niflumic acid is a prostaglandin synthetase inhibitor. It is important that the nephrotoxicity of this vasoactive drug be known. Maternal administration of niflumic acid during the last days of gestation can induce fetal and neonatal adverse effects, especially renal failure. Prescription of all nonsteroidal anti-inflammatory drugs must be very cautious during pregnancy.

[First trimester abdominal pregnancy and laparoscopic surgical treatment. 2 case reports of evolving abdominal pregnancy treated with laparoscopy at 10 and 12 weeks]. / Grossesse abdominale du premier trimestre et traitement coelio-chirurgical. A propos de deux cas de grossesse abdominale évolutive traités par coelioscopie à 10 et 12 semaines d'aménorrhée.

Abdominal pregnancy occurs rarely and few observations of laparoscopic surgical treatment have been published. We observed 2 cases at 10 and 12 weeks of amenorrhoea. During one of the operations, it was particularly difficult to establish haemostasis, demonstrating the problems involved with laparoscopic surgery, highly dependent on gestational age and trophoblastic localization. Based on the epidemiological and diagnostic data we propose a therapeutic protocol for laparoscopic surgery in first-trimester abdominal pregnancies, taking into consideration the cases previously reported and current care for extrauterine pregnancy and late abdominal pregnancy.

[In utero diagnosis of situs abnormalities. A case of prenatal diagnosis of visceral situs inversus with corrected transposition of great vessels]. / Diagnostic in utero des anomalies de situs. A propos d'un cas de diagnostic prénatal de situs inversus viscéral avec transposition corrigée des gros vaisseaux.

A case of situs inversus with discordant atrio-ventricular and ventriculo-arterial structures was diagnosed at the ultrasonography examination performed at 34 weeks gestation. This observation underscores the importance of recognizing the position of the viscerae and discordant segments of the heart, atria, ventricles and greater vessels. Overall frequency of situs inversus is estimated at 1/10,000 births. It is often associated with an inborn cardiopathy, especially corrected transposition of the greater vessels resulting from abnormal rotation of the cardiac tube. The anatomic, pathologic, embryologic, etiologic and and sonographic features of situs inversus and related anomalies of the cardiac structures is presented.

[Early prenatal diagnosis of asymmetric cephalothoracopagus twins]. / Diagnostic anténatal précoce de jumeaux céphalo-thoracopages asymétriques.

The authors report on one case of cephalothoracopagus Janiceps conjoined twins discovered by echography at 18 weeks' gestation. Conjoined twins have been said to occur with a frequency of 1/50,000 to 1/100,000 deliveries. The incidence of the cephalothoracopagus variety is one in three million births or one in 58 conjoined twins. Three different mechanisms that may have played a role in the abnormal development of these twins are discussed. The risk that the condition recurs in a subsequent pregnancy are to be considered negligible.

Giant hepatic cysts: prenatal findings and uncommon postnatal outcome.

With modern prenatal imaging, liver cysts are being diagnosed more often. Although large cysts are usually asymptomatic, they may present as an abdominal emergency requiring surgery in the first weeks of life. We report a series of 3 patients with prenatal diagnosis of isolated cystic liver lesions diagnosed at 22, 31 and 33 weeks of gestational age. The hepatic origin of the cysts was confirmed prenatally by a MRI in 2 cases, with visualization of a normal gallbladder. The prenatal course was uneventful. Postnatal ultrasound confirmed the diagnosis of liver cyst, showed normality of the biliary tract and in one case, rupture of the cyst during delivery. Because of an uncommon rapid increase in size, the 3 children underwent surgical excision of the cysts within the first weeks of life. These were non-bile-containing intrahepatic cysts arising from segment IV. Long-term follow up was uneventful.

[Use of the Logotampon in gynecologic-obstetrical surgical hemorrhages. A case report]. / L'utilisation du Logotampon dans les hémorragies en chirurgie gynéco-obstétricale. A propos d'un cas.

The authors report a case of placenta accreta complicated by coagulation disturbance which required hysterectomy. In order to deal with widespread bleeding, they used a Logotheotopoulos pelvic tampon (Logotampon) and thus achieved a satisfactory operative result.

[Primary Bartholin gland cancer and etiopathogenetic role of human papillomavirus. Report of a new case]. / Cancer primitif de la glande de Bartholin et rôle étiopathogénique du papillomavirus humain. Rapport d'un nouveau cas.

The authors report a new case of Bartholin's gland carcinoma and its link with human papillomavirus. Should women with HPV have Pap smears the accessory glands of the vulva in addition to cervical smears?

[Criteria for choice of vaginal hysterectomy for lesions other than invasive cancer]. / Critères de choix de la voie vaginale lors des hystérectomies pour lésions autres que cancer invasif.

The authors analyse in retrospect a continuous series of 208 hysterectomies, for lesions other than invasive cancer, in order to try to define precise objective criteria for the choice of the vaginal way. What essentially commands the choice of this way are: high parity, large size of the uterus, the existence of prolapsus, effort-linked urinary deficiency and no annexial pathology.